Maintenance of weight loss in overweight middle-aged women through the Internet
Abstract
OBJECTIVE: The purpose of this study was to compare weight regain in a group of perimenopausal women (48.0+/-4.4 years old), randomized to a 12-month weight maintenance Internet intervention or to self-directed weight maintenance after a 4-month weight loss treatment. METHODS AND PROCEDURES: After a 4-month behavioral weight loss program, 135 women were randomized to either Internet or self-directed groups. The Internet group (n=66) used a website to gain information and complete logs concerning their weight, diet, and exercise progress over a 12-month follow-up. The 69 self-directed women had no contact with study staff. All women were measured for weight and body composition, and diet intake, and were interviewed using the 7-day physical activity questionnaires at baseline, 4 months, and 16 months. RESULTS: At the end of the 12-month follow-up, the Internet and self-directed groups had regained on average 0.4+/-5.0 kg and 0.6+/-4.0 kg, respectively (P=0.5). In within-group analyses, Internet diet-log entries were correlated with follow-up weight change (r=-0.29; P<0.05) and moderately with change in exercise energy expenditure (EEE; r=0.44; P<0.01). Follow-up weight change was not correlated with change in dietary intake. DISCUSSION: While significant weight loss was maintained over follow-up by both groups of women, Internet use did not surpass self-direction in helping to sustain weight loss. Among Internet users, Internet use was related to weight change and EEE.
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At 12 months, participants in computer interventions regained less weight (MD −0.8 kg, 95% CI −1.4 to −0.2; P = 0.01; 1004 participants; three trials).
“and 12 months (MD −0.8 kg (95% CI −1.4 to −0.2); P = 0.01; 1004 participants; three trials; Analysis 5.2)”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Cussler 2008
In Cussler 2008, at 12 months, the computer intervention group had a smaller increase in energy intake but the difference was not statistically significant (MD −48 kcal/day, 95% CI −198 to 102; P = 0.53; 107 participants).
“One study (Cussler 2008) reported data on energy intake at 12 months (MD −48 kcal/day (95% CI −198 to 102); P = 0.53; 107 participants; Analysis 5.8)”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Cussler 2008
In Cussler 2008, almost one-third of the computer-based group accessed the Internet only once per week during maintenance.
“For example, almost one-third of the computer-based group accessed the Internet only once per week during maintenance.”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Cussler 2008
In Cussler 2008, at 12 months, there was no statistically significant difference between intervention groups in energy expenditure (MD −7 kcal/day, 95% CI −117 to 103; P = 0.90; 107 participants).
“One study (Cussler 2008) reported data on energy expenditure at 12 months; there was no statistically significant difference between intervention groups (MD −7 kcal/day (95% CI −117 to 103); P = 0.90; 107 participants; Analysis 5.10).”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Cussler 2008
In Cussler 2008, at 12 months of follow-up, the difference between intervention groups in BMI was small and not statistically significant (MD −0.4 kg/m2, 95% CI −0.3 to 1.1; P = 0.26; 688 participants).
“At 12 months of follow-up, the difference between intervention groups was small and not statistically significant (MD −0.4 kg/m2 (95% CI −0.3 to 1.1); P = 0.26; 688 participants; Analysis 5.7).”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Cussler 2008
In Cussler 2008, among participants who completed the study, there was a significant correlation between submission of diet logs and change in weight.
“Among participants who completed the study, there was a significant correlation between submission of diet logs and change in weight.”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Cussler 2008
In Cussler 2008, there was a wide range in adherence to intervention activities.
“Cussler 2008 used several measures of engagement with the computer-based intervention (e.g. submission of diet and weight logs, number of e-mail contacts, number of articles posted) and found a wide range in adherence to intervention activities.”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Cussler 2008
In Cussler 2008, no other measures of adherence were correlated with weight maintenance.
“No other measures of adherence were correlated with weight maintenance.”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Cussler 2008
Since the estimate of effect in Cussler 2008 was intermediate between that in the other two trials in the analysis, it is likely that the omission of the trial reduced the statistical significance of the effect estimate due to less information being present in the analysis.
“Since the estimate of effect in Cussler 2008 was intermediate between that in the other two trials in the analysis, it is likely that the omission of the trial reduced the statistical significance of the effect estimate due to less information being present in the analysis.”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Cussler 2008
When the cluster-randomized studies (Cussler 2008; Morgan 2011) were omitted from analyses, there were not large differences in the estimate of effect or the statistical significance of those analyses, with two exceptions.
“When we omitted the cluster-randomized studies (Cussler 2008; Morgan 2011) from analyses, there were not large differences in the estimate of effect or the statistical significance of those analyses, with two exceptions.”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Cussler 2008
In the analysis of change in weight maintenance at 12 months, the omission of Cussler 2008 did not change the pooled effect estimate of 0.8 kg, but altered the statistical significance from P = 0.01 to P = 0.08.
“In the analysis of change in weight maintenance at 12 months (Analysis 5.2), the omission of Cussler 2008 from the analysis did not change the pooled effect estimate of 0.8 kg, but altered the statistical significance from P = 0.01 to P = 0.08.”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Cussler 2008
Neve and colleagues observed that login frequency was associated with impact, consistent with what has been observed in a number of the individual trials in this review.
“Neve and colleagues observed that login frequency was associated with impact, consistent with what has been observed in a number of the individual trials in this review (Cussler 2008; Harvey-Berino 2004; Tate 2001; Tate 2003; Womble 2004).”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Cussler 2008
Of the 15 studies that mention adapting the design of the intervention to increase adherence, 8 studies do so without any theoretical basis or reference.
“Of the 15 studies that mention adapting the design of the intervention to increase adherence, 8 studies do so without any theoretical basis or reference [64-71]”
From Persuasive System Design Does Matter: a Systematic Review of Adherence to Web-based Interventions (2012) · cites this paper as [69]
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- Authors
- Cussler, E. C., Teixeira, P. J., Going, S. B., Houtkooper, L. B., Metcalfe, L. L., Blew, R. M., Ricketts, J. R., Lohman, J., Stanford, V. A., & Lohman, T. G.
- Affiliations
- University of Arizona (US)
- Universidade Técnica de Lisboa (PT)
- Corresponding author
- Lohman, Timothy G.
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2008-05
- Volume
- 16
- Issue
- 5
- Pages
- 1052-1060
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- OpenAlex
- W2075956298
- Cited by
- 115
- References
- 42
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 1 · 2023: 1 · 2022: 6 · 2021: 3 · 2020: 1 · 2019: 5 · 2018: 8 · 2017: 6 · 2016: 3 · 2015: 14 · 2014: 12 · 2013: 8 · 2012: 7
- FWCI
- 20.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK057453, DK57453)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- weight maintenance, weight regain, online intervention, perimenopausal women, middle-aged women, overweight, behavioral weight loss, exercise energy expenditure, physical activity, body composition, dietary intake
- MeSH terms
- Adult, Body Composition, Body Weight, Combined Modality Therapy, Diet, Reducing, Energy Metabolism, Female, Follow-Up Studies, Humans, Middle Aged, Self-Help Groups, Weight Loss, Exercise, Internet, Overweight
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